To: Board of Directors
From: Dr. Grant Colfax, Health Services Director
Report Title: Amendment #74-657-2 with California Mental Health Services Authority (CalMHSA)
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Amendment #74-657-2 with California Mental Health Services Authority (CalMHSA), a California joint powers agency, effective December 16, 2025, to amend Participation Agreement (County Contract #74-657, as amended by County Contract #74-567-1 (Amendment No. 1)), to increase the payment limit by $226,526 from $4,570,830 to a new payment limit of $4,797,356, to participate in CalMHSA’s contract with Streamline Healthcare Solutions, LLC, in additional program offerings, for a hosted mental health services electronic healthcare record system with no change in the term ending March 20, 2029.
FISCAL IMPACT:
This Amendment will result in additional contractual service expenditures of up to $226,526 over a 3-year period and will be funded as budgeted by the department in FY’s 2025-29 100% by Alcohol and Other Drug Services (AODS). (No rate increase)
BACKGROUND:
This Amendment (Amendment No. 2) meets the California Department of Health Care Services-mandated payment reform requirements of California Advancing and Innovating Medi-Cal (CalAIM) which the County must meet by providing SmartCare Base, a semi-statewide hosted, mental health services enterprise health record system provided by Streamline Healthcare Solutions, LLC, to act as a catalyst for better use of data to drive performance outcomes. SmartCare Base is a fully integrated, web-based Electronic Health Records (EHR) system designed for program, billing, and revenue management to support core business requirements and address all regulatory requirements specific to the State of California by establishing consistent workflows, configuration, and functionality. Contra Costa Health Services’ implementation of SmartCare Base focused on AODS healthcare providers and organizations that offer psychiatric inpatient, outpatient, residential and community-based programs. SmartCare Base includes (but is not limited to) clinical and administrative functionality for client intake and registration, individual care planning, prescription medication orders, document management, compliance monitoring, and productivity and outcomes measurement tools. In addition, SmartCare Base meets the requirements of Medi-Cal and includes the ability to capture data, transmit and monitor the submission process, provide reporting capabilities, check or confirm Medi-Cal Eligibility, Treatment Authorization Request (TAR) creation and submission, as well as Medi-Cal, required elements for proper claim submission.
To govern this program, CalMHSA entered into a Master Services Agreement (MSA) with Streamline Healthcare Solutions, LLC., dated March 20, 2022, and terminating on March 20, 2029, that includes the option to extend the MSA for up to three (3) additional one (1) year periods.
On October 25, 2022, the Board of Supervisors approved County Contract #74-657 with CalMHSA in an amount not to exceed $4,570,830, for the County to participate in CalMHSA’s contract with Streamline Healthcare Solutions, LLC a semi-statewide hosted AODS enterprise health records software system for the period October 25, 2022, through March 20, 2029, under which the parties executed a Participation Agreement (PA) allowing the County to receive the software and services contracted by CalMHSA under the MSA. Under the PA, CalMHSA will invoice the County for the services, and CalMHSA shall make payments to Streamline therefor, on the County’s behalf, as set forth in the Order Form between Streamline and CalMHSA for the services the County is to receive. The County may extend PA to reflect any extensions of the MSA. Under the PA, Streamline’s liability is limited to $10 million except with respect to breaches of data or death or bodily injury.
On November 29, 2023, AODS Division Director executed Agreement No.: 1683-HER-2022-CCC-A1 (Amendment No. 1) with CalMHSA for the purchase of professional services to implement the Single Sign On (SAML) solution and reallocate funds ($4,600) from Participant Contingency Budget (Exhibit D-1) to Participant-Specific Committed Funding (Exhibit C-1).
Approval of this Contract Amendment #74-657-2 updates the Business Associate Agreement appended to the Contract, incorporates additional programmatic purchase(s), removes certain subscriptions, and allows the Contractor to provide additional services through March 20, 2029.
CONSEQUENCE OF NEGATIVE ACTION:
If this Amendment is not approved, the County will be unable to participate in additional programming regarding CalAIM-required payment reform, disallowing its ability to bill for some AODS services risking millions of dollars in CCH revenue and putting patient care in jeopardy.